CONTEXT AND OBJECTIVE: Alzheimer's disease is a common cause of dementia and identifying possible spatial patterns of mortality due to this disease may enable preventive actions. The objective of this study was to identify spatial distribution patterns of mortality due to Alzheimer's disease in the state of São Paulo.DESIGN AND SETTING: Ecological and exploratory study conducted in all municipalities in the state of São Paulo.METHODS: Data on Alzheimer's disease mortality in the state of São Paulo between 2004 and 2009 were obtained from DATASUS (the Department of Informatics in the Brazilian Ministry of Health). Death rates per 100,000 inhabitants were then calculated and spatial analysis was performed by constructing a death rate map, global Moran index and local Moran index, which were used to obtain the Moran map. The kernel technique was also applied. The Terra View 4.0.0 software was used.RESULTS: 13,030 deaths due to Alzheimer were reported in the state of São Paulo (rate of 5.33 deaths/100,000 inhabitants). São José do Rio Preto, Ribeirão Preto, Bauru and Araçatuba had higher rates. The Moran index was I = 0.085 (P < 0.002). The Moran map identified 42 municipalities that merit intervention and the kernel estimator identified a high density of deaths in the northwestern region of the state.CONCLUSION: Higher densities of deaths due to Alzheimer were concentrated more to the north and northwest of the state of São Paulo. It was possible to identify municipalities that have priority for interventions to reduce the death rates due to this disease.
This study demonstrated that neonatal mortality rate would be close to the rates of developed countries if avoidable causes were abolished.
A leucemia linfoide aguda é neoplasia maligna mais comum em crianças. O objetivo deste estudo foi identificar padrões espaciais da incidência de leucemia linfoide aguda em crianças no Estado de São Paulo, entre 2000 e 2009, e associá-los a possíveis exposições a poluentes ambientais. Foi um estudo ecológico e exploratório com dados obtidos da Fundação Oncocentro de São Paulo e utilizando as ferramentas da análise espacial obtendo os valores dos índices de Moran e construindo mapas temáticos com as taxas de incidência de leucemia, com os dados do Box Map e do estimador de Kernel. Foram identificados 1637 casos novos de leucemia linfoide aguda no estado de São Paulo. As taxas encontradas variaram de 0,0 até 47,6 casos por 100.000 habitantes. Municípios com maiores taxas: Cândido Rodrigues com 47,6 casos por 100.000 habitantes e Santa Rita D´Oeste com 35,0. Obteve-se um índice Global de Moran de I = 0,08 (p = 0,01). O Box Map identificou 96 municípios com alta prioridade de intervenção por parte dos gestores da saúde. O estimador de Kernel permitiu visualizar uma densidade maior de taxas na região noroeste do estado que coincide com a região em que há maior produção de laranja. Os resultados apresentados neste estudo fornece informações aos gestores de saúde para identificar possíveis fatores associados.
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